Bilateral filtering based sliding motion compensated 4D-CBCT: a simulation study / 中国辐射卫生

Objective This study reconstructed 4D-CBCT for fully automatic compensated sliding motion by incorporating the bilateral filtering into the Deformable Vector Field (DVF). Methods First, a motion compensated simultaneous algebraic reconstruction technique (Modified Simultaneous Algebra Reconstruction Technique, mSART) was used to generate a high quality reference phase by using all phase projection stogether with the initial 4D-DVFs, which were generated via Demons registration between 0% phase and each other phaseimage. The 4D-DVF was optimized by matching the forward projection of the deformed 0% phase with the measured projection of the target phase. The loss function’s DVF smoothing constrain term contained bilateral filtering kernel that contained: 1) an spatial domain Guassian kernel; 2) animage intensity domain Guassian kernel; and 3) a DVF domain Guassian kernel. By choosing suitable kernel variances, the sliding motion can be extracted. A non-linear conjugate gradient optimizer wasused. We validated the algorithm on a Non-Uniform Rotational B- spline based Cardiac-Torso (NCAT) phantom. Quantification was evaluated by: 1) the Root-Mean-Square-Error (RMSE) together with the Maximum-Error (MaxE); 2) the Dice coefficient of the extracted lung contour from the final reconstructed images and 3) the relative reconstruction error (RE) to evaluate the algorithm's performance. Results The motion trajectory's RMSE/MaxEare 0.796/1.02 mm for bilateral filtering reconstruction; and 2.704/4.08 mm for original reconstruction. Image content such a stherib position, the hearted gedefinition, the fibrous structures all had been better corrected with bilateral filtering. Conclusion We developed a bilateral filtering based fully automatic sliding motion compensated 4D-CBCT scheme. Digital phantom study confirmed the improved motion estimation and image reconstruction ability. It can be used as a 4D-CBCT image guidance tool for lung SBRTtreatment.

The effects of bone graft combined with enamel matrix derivative in the treatment of periodontal osseous defects compared with that of bone graft alone: A meta-analysis / 实用口腔医学杂志

Objective: To analyze the efficacy of enamel matrix derivative (EMD) combined with bone grafts in the treatment of periodontal osseous defects comparied with that of bone grafts alone by Meta-analysis. Methods: The randomized controlled trials(RCTs) about the efficacy of enamel matrix derivative and bone grafts for the treatment of periodontal osseous defects were collected from Cochrane Library,EMBASE,PubMed,CNKI,Wanfang databases and Google scholar from inception may,2016 by electronic search,scored literatures with the methodological index for non-randomized studies(MINORS) evaluation tool. Revman 5. 3 was used for the Meta-analysis. Results: 5 RCTs articles with 145 cases were included. Meta-analysis showed that: at 6 months of follow-up, PD reduction and CAL gain was found more in test group than in control group(WMD = 0. 40,95％ CI =[0. 01,0. 79],P ＜ 0. 05) and (WMD = 0. 50,95％ CI =[0. 12,0. 88],P ＜ 0. 05) respectively. At 12 months of follow-up,there was no statistical significant difference in PD reduction and CAL gain respectively between the 2 treatments. Conclusion: The combined use of EMD and bone grafts may improve PD reduction and CAL gain in the early stage of convalescence following treatment of periodontal osseous deffects.

Clinical study of anterior controllable antedisplacement and fusion for the treatment of cervical ossification of posterior longitudinal ligament / 中华骨科杂志

Objective To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) for the treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine.Methods The data of 45 cases with cervical posterior longitudinal ligament ossification treated by ACAF from March 2017 to October 2017 were retrospectively analyzed,including 25 males and 20 females,age 45-68 years,average 57.5 years.There were 18 cases involving C3 vertebral body,30 cases involving C4 vertebral body,40 cases involving C5 vertebral body,34 cases involving C6 vertebral body,and 7 cases involving C7 vertebral body.The function of the neural function was evaluated by the Japanese Orthopaedic Association (JOA) scoring system at preoperation and latest follow-up.The curvature of the cervical spine was measured on the lateral X-ray film of the cervical spine,the maximum occupying ratio of the spinal canal was measured on the cross section of the CT scan,and compression of the cervical spinal cord was evaluated by the cervical MRI.Results Patients were followed up for 3 to 6 months (average,3.9 months).The improvement of neurological function was obtained in all the patients.The JOA score improvement rate at the latest follow-up was 71.3％±9.6％.The cervical lordosis was improved from preoperative 4.5°±3.8° to 10.3°±4.8° at the latest follow-up.The canal stenosis ratio was decreased from preoperative 54.3％±8.2％ to 12.5％±5.3％ at the latest follow-up.MRI showed that the cervical spinal cord was adequately decompressed in situ.No specific complications were identified that were associated with this technique.Conclusion The present study elaborates the surgical tips and demonstrates the satisfactory outcome of ACAF for the treatment of OPLL.This novel technique has the potential to serve as an alternative surgical technique for the treatment of cervical OPLL.

Anterior controllable anteriodisplacement and fusion for treatment of severe cervical ossification of posterior longitudinal ligament / 第二军医大学学报

Objective To report a novel technique named anterior controllable antedisplacement and fusion (ACAF) for the treatment of severe ossification of the posterior longitudinal ligament of the cervical spine,which allows for direct decompression of the nerve without resection of the ossification,making up for deficiencies in traditional anterior or posterior decompression.Methods The main surgical procedures of the ACAF included treatment of intervertebral space,removal of the anterior part of vertebrae,installation of titanium plate and interbody fusion cages,bilateral osteotomies of the vertebrae,and antedisplacement of the vertebrae ossification complex.The clinical data of two patients undergoing this surgery for severe ossification of the posterior longitudinal ligament of cervical spine were collected and analyzed.Results ACAF enabled direct decompression of spinal cord and nerve root through antedisplacement of the vertebrae ossification complex.The two patients who underwent ACAF gained satisfactory restoration with decompression of spinal cord and good recovery of neurological function,with no specific complications.Conclusion ACAF surgery takes into account the effectiveness of anterior direct decompression and the safety of posterior indirect decompression.Preliminary results shows that it can be used for severe cervical ossification of the posterior longitudinal ligament.

Volumetric changes in the upper airway after orthodontic-orthoganthic surgery for the treatment of skeletal Class Ⅲ malocclusion: A meta-analysis / 实用口腔医学杂志

Objective:To evaluate volumetric changes in the upper airway after orthodontic-bimaxillary surgery for the treatment of skeletal class Ⅲ malocclusion.Methods:Literatures about volumetric changes in the upper airway after orthodontic-bimaxillary surgery for the treatment of skeletal class Ⅲ malocclusion were searched from the database:Cochrane library,Embase,PubMed,Web of Science,Wangfang,China Science and Technology Journal Database (VIP),Chinese Biomedical Medicine Database (CBM) and China National Knowledge Infrastructure(CNKI).All the literatures were evaluated by Newcastle-Ottawa Scale(NOS) and analyzed by RevMan 5.3.Results:9 studies with 204 cases about volumetric changes in the upper airway after orthodontic-bimaxillary surgery for the treatment of skeletal Ⅲ malocclusion were included.Meta-analysis showed that after treatment there was no statistical difference about the nasopharyngeal volume change and the total volume change(P＞0.05);there was statistically significant difference about oropharyngeal volume change (P＜0.05).Conclusion:It might be better to consider orthodontic-bimaxillary surgery for skeletal class Ⅲ malocclusion with certain risk factors about OSAHS,but there was still a risk of airway narrow after orthodontic-bimaxillary surgery for skeletal class Ⅲ malocclusion.

Titanium mesh cage subsidence following anterior subtotal vertebrectomy for cervical spondylosis: the underlying mechanism and its effect on cervical neurologic function / 中国组织工程研究

BACKGROUND: Anterior subtotal vertebrectomy and fusion using titanium mesh cage (TMC) is an effective surgical treatment for cervical spondylosis, while TMC subsidence usually occurs. The risk factors for TMC subsidence and its effect on the treatment outcomes remain controversial. OBJECTIVE: To investigate the TMC subsidence after anterior subtotal vertebrectomy and TMC fusion and its effect on the treatment outcomes, thereby understanding the underlying mechanism and related risk factors. METHODS: Clinical data of 34 patients undergoing anterior subtotal vertebrectomy and TMC fusion in the Second Department of Spine, Shanghai Changzheng Hospital Affiliated to the Second Military Medical University from March to September 2015 were analyzed retrospectively. After 12-month follow-up, the height of the fused segments was measured, and the neurologic outcomes were evaluated using the Japanese Orthopedic Association scores. The loss of the fused segments subsided more than 3 mm compared with that at 1 day postoperatively was considered as TMC subsidence, and all patients were allotted to TMC subsidence and control (without TMC subsidence) groups.RESULTS AND CONCLUSION: (1) Totally 19 patients (56%) experienced TMC subsidence that occurred in postoperative (6.00±3.73) months averagely. (2) No significant differences were found in the age, sex or the level of fused segments between two groups (P=0.731, 0.672, 0.053). (3) The Japanese Orthopedic Association recovery ratio in the control group was significantly higher than that in the TMC subsidence group (P=0.01), suggesting that TMC subsidence might be correlated with the poor improvement of neurologic function after surgery. (4) To conclude, TMC subsidence is a common complication after anterior subtotal vertebrectomy, which does harm to the treatment outcomes.Moreover, age, sex or the level of fused segments are not independent risk factors for TMC subsidence.

Expression of miR-183-5p, TβRⅠand TβRⅡin esophageal squamous cell carcinoma Zhu Longping, You Jianliang, Hu Pingping, Mao Chaoming, Chen Deyu / 肿瘤研究与临床

Objective To study the expression and clinical significance of miR-183-5p, TβRⅠ and TβRⅡ in esophageal squamous cell carcinoma (ESCC). Methods The mRNA and protein expression of miR-183-5p, TβRⅠ and TβRⅡ were examined in ESCC cell lines ECA-109, TE-1, normal esophageal epithelial cells, tumor tissues and tumor-free tissues from 72 ESCC patients. Their clinical significance and the relationship between miR-183-5p and the latter two were analyzed. The effects of miR-183-5p on the expression of TβRⅠand TβRⅡ in ECA-109 cells and the cell functions of ECA-109 were also investigated. Results Compared with the normal esophageal epithelia cells, ESCC cell lines TE-1 and ECA-109 were statistically characterized by a high expression of miR-183-5p (all P<0.05) and low expression of TβRⅠand TβRⅡ(all P<0.05). The expression of miR-183-5p in ESCC tissues was higher than that in adjacent normal tissues, while the expressions of TβRⅠ and TβRⅡ were lower (all P< 0.05). The expression of miR-183-5p was closely related to sex, tumor differentiation, tumor staging, distant metastasis, lymphatic metastasis, and tumor location (all P<0.05). TβRⅠlevel was associated with sex, lymph node metastasis and tumor size (all P<0.05). Experimental data showed the negative correlation between the expression of miR-183-5p and TβRⅠin ESCC tissues (r= -0.521, P< 0.05). Over expression of miR-183-5p significantly inhibited the expression of TβRⅠ in ECA-109 cells (P< 0.05) and promoted the growth, invasion and metastasis of ECA-109 cells (P< 0.05). Low expression of miR-183-5p significantly promoted the expression of TβRⅠ in ECA-109 cells (P< 0.05), and suppressed the growth, invasion and metastasis of ECA-109 cells (P< 0.05). There was no significant change in the expression of TβRⅡ in the transfection experiments. Conclusion MiR-183-5p is closely related to the abnormal expression of TβRⅠ, which may exert an important role in the progression of lymphatic metastasis.

Management and Outcomes of Cerebrospinal Fluid Leak Associated With Anterior Decompression for Cervical Ossification of the Posterior Longitudinal Ligament With or Without Dural Ossification.

STUDY DESIGN: A retrospective clinical study. OBJECTIVE: To analyze and evaluate the clinical outcomes of cerebrospinal fluid (CSF) leak after anterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL) with or without dural ossification (DO). SUMMARY OF BACKGROUND DATA: Anterior decompression can be highly efficacious in the treatment of OPLL. However, in some cases of OPLL, there often exists DO and fusion with the posterior longitudinal ligament, which may increase the chance for CSF leak during an anterior decompression surgery. MATERIALS AND METHODS: A retrospective analysis was performed on 126 OPLL patients (89 men and 37 women) treated with anterior decompression surgery between January 2008 and January 2012. The mean age at operation was 61 years (ranging from 46 to 72 y) and the average duration of diagnosis was 4.2 years (ranging from 3 d to 7 y). DO was present in 11 patients, of whom 7 developed dural tear or defect. Among the 115 patients without DO, only 4 developed dural tear. Intraoperative dural repair was performed with gelatin foam onlay and fibrin glue seal. Postoperative care for CSF leak involved bed rest, CSF drainage, nutritional support, and antibiotics. RESULTS: A total of 11 cases associated with dural tear or defect developed postoperative CSF leak (an overall incidence of 8.7%). There was a statistically significant difference (P<0.001) in the incidence of CSF leak between the DO group (63.6%) and the non-DO group (3.5%). While leakage in 3 patients resolved spontaneously within 5 days of surgery, intermittent CSF cysts developed in 8 patients. These were treated with circular pressure bandages, repeated aspiration, and lumbar drainage. All 8 cases resolved 14-30 days after surgery. These 11 patients were followed up for an average of 12.8 months (range of 1 to 36 mo) with an average Japanese Orthopedic Association score of 51.2% and no significant neurological deficit or persistent headaches were recorded. CONCLUSIONS: Patients with DO are at increased risk for dural injury while undergoing anterior decompression for the treatment of OPLL. This is associated with a high incidence of CSF leak. However, the majority of patients with CSF leak could be managed conservatively.

Expression of bone morphogenetic protein-2 and bone morphogenetic protein-4 in Skeletal Class Ⅱ Malocclusion during growth peak / 中国组织工程研究

BACKGROUND:Preliminary studies of our research group have confirmed that bone morphogenetic protein-4 can stimulate the development of mandible in the growth period, but whether bone morphogenetic protein-4 can interact with bone morphogenetic protein-2 to promote the growth of mandible has not been reported. OBJECTIVE:To detect the expression of bone morphogenetic protein-2 and bone morphogenetic protein-4 in skeletal class II malocclusion during growth peak, and to explore the relationship of the expression of bone morphogenetic protein-2 and bone morphogenetic protein-4 with mandibular growth. METHODS: Patients with skeletal class I malocclusion in growth peak served as group I, and those with skeletal class II malocclusion in growth peak characterized as mandibular retrognathia acted as group II. There were 18 cases in each group. Expression of bone morphogenetic protein-2 and bone morphogenetic protein-4 in serum was detected by real-time fluorescent quantitative PCR. RESULTS AND CONCLUSION:The mRNA expression of bone morphogenetic protein-2 and bone morphogenetic protein-4 in the group II was significantly lower than that in the group I (P < 0.05). In the group II, there was a significant correlation between the expression of bone morphogenetic protein-2 and bone morphogenetic protein-4. These experimental findings confirm that the reduced expression of bone morphogenetic protein-2 and bone morphogenetic protein-4 in skeletal class II malocclusion during growth peak has a certain relationship with mandibular deficiency, and moreover, bone morphogenetic protein-2 interacts with bone morphogenetic protein-4 to promote the growth of mandible.

Evaluation of a new type of titanium mesh cage versus the traditional titanium mesh cage for single-level, anterior cervical corpectomy and fusion.

STUDY DESIGN: A retrospective review of prospectively collected data in an academic institution. OBJECTIVE: To evaluate the safety and efficacy of a new type of titanium mesh cage (TMC) in single-level, anterior cervical corpectomy and fusion (ACCF). METHODS: Fifty-eight patients consecutive with cervical spondylotic myelopathy (CSM) from cervical degenerative spondylosis and isolated ossification of the posterior longitudinal ligament were treated with a single-level ACCF using either a new type of TMC (28 patients, group A) or the traditional TMC (30 patients, group B). We evaluated the patients for TMC subsidence, cervical lordosis (C2-C7 Cobb and Cobb of fused segments) and fusion status for a minimum of 30 months postoperatively based on spine radiographs. In addition, neurologic outcomes were evaluated using the Japanese Orthopedic Association (JOA) scores. Neck pain was evaluated using a 10-point visual analog scale (VAS). RESULTS: The loss of height of the fused segments was less for group A than for group B (0.8 ± 0.3 vs. 2.8 ± 0.4 mm) (p < 0.01); also, there was a lower rate of severe subsidence (≥3 mm) in group A (4 %, 1/28) than in group B (17 %, 5/30) (p < 0.01). There were no differences in the C2-C7 Cobb and Cobb of fused segments between the groups preoperatively or at final follow-up (p > 0.05), but the Cobb of fused segments immediately postoperative were significantly less for group B than for group A (p < 0.01). All patients, however, had successful fusion (100 %, each). Both groups had marked improvement in the JOA score after operation (p < 0.01), with no significant differences in the JOA recovery ratio (p > 0.05). The postoperative VAS neck pain scores for group A were significantly less than that for group B (p < 0.05); severe subsidence was correlated with neck pain. CONCLUSIONS: The new type of TMC provides comparable clinical results and fusion rates with the traditional TMC for patients undergoing single-level corpectomy. The new design TMC decreases postoperative subsidence (compared to the traditional TMC); the unique design of the new type of TMC matches the vertebral endplate morphology which appears to decrease the severity of subsidence-related neck pain in follow-up.

Dysphagia after anterior cervical discectomy and fusion: a prospective study comparing two anterior surgical approaches.

BACKGROUND: The Smith-Robinson approach is commonly used to expose the vertebrae in anterior cervical discectomy and fusion (ACDF). Postoperative dysphagia has been frequently reported following this procedure. In this approach, surgical dissection can be carried out either lateral (LEO) or medial (MEO) to the omohyoid muscle. The purpose of this study was to compare the degree of dysphagia between the LEO and MEO groups. METHODS: In this randomized, prospective study, 80 patients were enrolled and evenly divided into the MEO and LEO groups. Patients underwent two-level ACDF using a right-sided Smith-Robinson approach. Follow-up was obtained 1, 3, 6, 12 week and 6 months after surgery. The degree of dysphagia was assessed using a 14-item questionnaire from the SWAL-QOL survey. RESULTS: There were no differences between the MEO and LEO groups with respect to age, gender, body mass index, or length of surgery. Overall, the SWAL-QOL scores were not different between the two groups at any of the follow-up time points. However, when the level of surgery was taken into consideration, the early postoperative SWAL-QOL scores were significantly lower in the C3-C4 subgroup when the MEO approach was used. Conversely, the SWAL-QOL scores were significantly lower in the C6-C7 subgroup when the LEO approach was used. Two patients with C6-C7 surgery in the MEO group also developed dysphonia that resolved spontaneously within 3 months. CONCLUSION: The findings from this study suggest that the LEO approach should be selected if the level of surgery involves C3-C4. For C6-C7 surgery, however, a left-sided MEO approach should be used. Depending on surgeon's preference, either approach can be used if both cervical levels are involved.

Trauma-induced spinal cord injury in cervical spondylotic myelopathy with or without lower cervical instability.

Dynamic factors are important contributors to neurologic deficits in cervical spondylotic myelopathy (CSM) patients. Between 2005 and 2009, we retrospectively investigated 72 patients with CSM with or without lower cervical instability for their neurologic status after low-energy trauma and surgery. Patients were divided into two groups: the instability group and the stability group. The neurologic status was evaluated using the Japanese Orthopaedic Association (JOA) scoring system. The incidence of neurologic deterioration after trauma was higher in patients with lower cervical instability than in those without (p<0.05). Patients in the instability group had a lower preoperative JOA score (p<0.05) and experienced less post-surgery improvement in neurologic function than those in the stability group (p<0.01). Even a minor trauma to the neck can lead to irreversible spinal cord injury for patients with CSM with cervical instability. Eliminating local instability through surgical and non-surgical methods is necessary for such patients before decompression and fusion surgery.

Expression and clinical significance of UL16 binding protein 3 in esophageal squamous cell carcinoma and its correlation with nature killer ceils / 中华消化杂志

Objective To investigate the expression and clinical significance of UL16 binding protein 3 (ULBP3) in human esophageal squamous cell carcinoma (ESCC) and its correlation with nature killer (NK) cells.Methods The relative expression of ULBP3 in the ESCC tissues and corresponding carcinoma adjacent tissues of 40 patients was detected by realtime-poly merase chain reaction (PCR),immunohistochemical staining and Western blot methods.The percentage of NK cells in peripheral blood of same patients was examined by flow cytometry.The correlation between ULBP3 and the percentage of NK cells was analyzed with Pearson method.Results The expression of ULBP3 at mRNA level in the tumor tissues ([4.96 ±-6.11]×10-3) was significantly higher than that of corresponding carcinoma adjacent tissues ([1.64 ± 2.96]× 10-3,t =3.656,P＜ 0.01).The immunohistochemical staining results indicated that the positive rate of ULBP3 in the tumor tissues was 60％ (24/40),however that of corresponding carcinoma adjacent tissues was only 32.5％(13/40,t=3.921,P＜0.01).The Western blot results indicated that the expression of ULBP3 at protein level in the tumor tissues was significantly higher than that in the corresponding carcinoma adjacent tissues.The relative expresssion ULBP3 at mRNA level in carcinoma tissues of ESCC patients with lymph node metastasis and at TNM stage Ⅲ was higher than that of ESCC patients without metastasis and at TNM stage Ⅰand Ⅱ (t=4.839,4.192,P＜0.05).There was no significant correlation between the expression and ages,gender,location of tumors and the differentiation degree of tumor (P＞0.05).At early and mid stage of the tumor,the expression of ULBP3 at mRNA level was positively correlated with the percentage of NK cells in peripheral blood (r=0.5233,P＜0.05),however there was no correlation at advanced stage.Conclusion ULBP3 was highly expressed in ESCC and may be involved in the immune regulation of NK cells.

Comparison of incidence of C5 nerve palsy after laminoplasty and laminectomy with internal fixation / 中华骨科杂志

ObjectiveTo compare the incidence of C5 nerve palsy after laminoplasty and laminectomy with internal fixation for treating multilevel cervical spondylotic myelopathy (MCSM).MethodsFrom January 2005 to June 2010,68 patients with MCSM were treated with laminoplasty (27 patients,group A) or laminectomy with internal fixation(41 patients,group B).There were 21 males and 6 females in group A,aged 33-80 years(average,60.4 years),31 males and 10 females in group B,aged 22-77 years (average,58.7 years).All the patients were followed up for 12-48 months (average,22 months).In both groups,Cobb's method was applied to measure cervical lordotic angle,and Ishihara's method was conducted to measure cervical curvature index(CCI) before and after operation.The incidence of C5 nerve palsy was recorded and compared.Then we further compared preoperative and postoperative the cervical lordosis angle and CCI of 9 patients with C5 nerve palsy (group B1) and 32 patients without C5 nerve palsy (group B2) in group B.ResultsThe incidence of C5 nerve palsy in group A was 3.7％(1/27),while 22.0％(9/41) in group B (x2=4.32,P＜0.05).For all ten patients with C5 nerve palsy,the muscle strengths of paralyzed muscles were recovered to grade 4 or better after being treated with conservative treatment for an average of 14 months.The change rate of preoperative and postoperative CCI in group B1 was 38.07％±18.03％,while 22.81％±12.71％ in group B2.There was a statistical difference between group B1 and group B2 (t=2.88,P＜0.05).Conclusion Compared with laminoplasty,laminectomy with internal fixation has a higher incidence of C5 nerve palsy.The C5 nerve palsy may be associated with postoperative increase of cervical lordosis angle.Moreover,tethering of the C5 root may be one of its important pathomechanisms.

Anterior decompression and autograft fusion under video-assisted thoraco-scopic to treat lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury / 中华骨科杂志

ObjectiveTo study the effect of anterior decompression and autograft fusion under video-assisted thoracoscopic to treat lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury.MethodsEleven patients who suffered from lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury were treated with anterior decompression and autograft fusion under video-assisted thoracoscopic from December 2005 to May 2008.The involved vertebrae included T12 in 5cases,T11 in 4 cases,T10 in 1 case and Ts in 1 case.According to the AO classification,4 patients were A2.2and 7 were A3.According to the Frankel classification,5 patients were rated as grade A,2 as grade C,2 as grade D and 2 as grade E.ResultsEvery patient underwent successful operation.The operation time was 3.5-8 h(average,5.2±1.6).The blood loss was 600-3800 ml(average,1195±576).One patient got intercostal neuralgia after operation,which disappeared after treating with analgesic drugs for 7 days.All patients were followed up for 36-65 months (average,49.5±5.9).All patients got bony fusion according to the CT scans 24month after operation.There were no neurological function deterioration and other instrument complications happened.At the last follow-up,5 patients were rated as grade A,2 as grade D and 4 as grade E,according to the Frankel classification.ConclusionAnterior decompression and autograft fusion under video-assisted thoracoscopic is an effective method to treat lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury.However,this method needs higher technology and has a long study-curve.

Causes tar and management of in anterior cervical surgery related nerve injuries / 中华创伤杂志

Objective To review the relevant causes for and treatment of nerve injuries in the anterior cervical surgery. Methods From January 2008 to December 2009,859 cages of cervical spondylosis,ossification of cervical posterior longitudinal ligament and cervical spine trauma were treated by anterior cervical surgery.This study retrospectively analyzed the clinical data of seven cases who were with worsened symptoms of spinal cord injury and related nerve injury. Results Of 859 cases,five cases(0.58%)were with spinal cord injury,one(0.12%)with recurrent laryngeal nerve injury and one (0.12%)with laryngeal nerve injury.Hematoma occurred in four cases after surgery caused spinal cord injury and all the four patients recovered to normal after removal of the hematoma and timely treatment with mythylprednisolone and hyperbaric oxygen.Cervical spine trauma was worsened in one patient after the anterior cervical surgery.The patient restored to its original level of spinal cord gradually through some measures such as tracheotomy,ventilator support,hormone therapy and hyperbaric oxygen treatment.Laryngeal nerve injuries in two cases recovered to normal after conservative treatment with hormone,dehydration and other drugs within three months after surgery. Conclusions Anterior cervical surgery of cervical spondylosis,ossification of cervical posterior longitudinal ligament and cervical spine trauma are likely to induce the related nerve damage.The good prognosis can be obtained under timely prevention and treatment.

Expression and regulation of HES1 in sperms with low motility from asthenospermia patients / 基础医学与临床

Objective To analyze the expression and regulation of HES1 in sperms with low motility.Methods Thirty semen samples from asthenospermia patients and 20 semen samples from healthy and fertile adults were collected,total RNAs were extracted to produce cDNAs probes.Hybridization with Phalanx OneArray~(TM) containing 30 968 probes was carried out after the labeled cDNAs were purified by PCR product purification kit.Realtime RT-PCR was used to analyze the expression of hsa-miR-487a and hsa-miR-193b;the expression of the target genes of hsa-miR-487a and hsa-miR-193b were searched from gene-expression profiles in asthenospermia patients' sperms.Results The expression level of HES1 in low motility sperms was up-regulated.The expression level of hsamiR-193b in low motility sperms was 2.19 times higher than that in high motility sperms,hsa-miR-487a was 0.43% of that in high motility sperms.Conclusion The expression level of HES1 in low motility sperms was up-regulated.Hsa-miR-487a and hsa-miR-193b may affect the expression of HES1 and so regulate sperm motility.

Slienced TROP2 gene inhibits the migration and invasion of gastric cancer BGC-823 cells in vitro / 基础医学与临床

Objective To investigate the role of TROP2 in migration and invasion of human gastric cancer cells. Methods Small interfering RNA(siRNA) targeting TROP2 gene was constructed by gene cloning and transfection into gastric cancer cell line BGC-823. The expression of mRNA and protein were detected by Real-time quantitative PCR and Western blot assay after RNA interference. The proliferation was determined by MTT assay. Transwell assay was performed to assess the effect of TROP2 targeted RNA interference on the migratory and invasive properties of gastric cancer in vitro. Results Enzyme digestion analysis and DNA sequencing showed that TROP2 targeted RNA interference recombinant plasmids were successfully constructed. The most effective recombinant plasmid was selected. After transfection, knockdown of TROP2 significantly inhibited the proliferation, migration and invasion of BGC-823 cells in vitro(P <0. 05). Conclusion Interfering and down-regulating TROP2 gene can inhibit migration and invasion of gastric cancer cell line BGC-823 in vitro, indicating that TROP2 gene is a potential target for gastric cancer gene therapy.

Postoperative progression and its analysis of ossification of the posterior longitudinal ligament on cervical spine / 中华骨科杂志

Objective To investigate and analyze the postoperative progression of ossification of the patients with ossification of the posterior longitudinal ligament (OPLL) on cervical spine. Methods From Jaunary 2001 to December 2007, 95 postoperative patients with cervical OPLL were followed and analyzed retrospectively. There are 72 males, 23 females, with the average age of 56.3 years (range, 40-73years). The follow-up time was from 1 to 6 years, average 3.1 years. Among them 36 patients were performed with anterior cervical corpectomy, fusion with titanium mesh and fixed with cervical plates, others treated with posterior cervical laminectomy and fixation. 2 of the 95 cases were performed anterior and posterior combined operation. Clinical data, X-rays, CT and MR images and progression of ossification, were measured and analyzed in details .The relationships between the progression of ossification and relative factors, as gender, age, C3 ossified involved, T-OPLL, OPLL-type, time of follow-up, surgical approach, Japanese Orthopaedic Association (JOA) scores and improvement rate of JOA scores, were analyzed. Results Progression of ossification in 39 cases among the 95 followed postoperative OPLL patients, 28 men and 11 women, average age 55.9 years, range 41-71 years. The age of progressed patients included 12 cases of ≤49 years, 12of 50-59 years, 12 of 60-69 years and 3 of ≥70 years. 35 patients were operated by posterior approach and only 4 treated with anterior operation. According to the standard of the progression of ossification that 2 mm in the length or/and thickness, there are 4 cases progressed only in length, 2 only in thickness, other 33 patients both the length and thickness. Progression of length is from 2mm to 20mm (average 7.74±4.71). But thickness is progressed from 2 mm to 6 mm (average 2.67±1.51). From 1 to 3 years follow-up time it appeard as a downtrend about the progression of ossification. But it may appear an uptrend from the 4th year. JOA score and improvement rate of the JOA score were almost improved to the high-point in three years. And according to the statistic data there are obvious relationship between progression of ossification with age, surgical approach and C3 ossified involved. Conclusion There is a high rate of postoperative ossification progression in cervical OPLL patients. Cervical OPLL patients with C3 ossification involved, performed with posterior laminectomy and those young at surgery may have higher rate of progression of the ossification. The JOA score and improvement rate of the JOA score were little influenced by the progression of the OPLL during the short and intermediate-term follow-up.

Treatment of odontoid fractures with Gallie technique with titanium cable fixation and Harms C1,2 screw fixation: a comparative study / 中华创伤杂志

Objective To compare the dinical outcome of posterior Gallie method with cable fixation and Harms technique with C1,2 pedicle screw fixation in treatment of odontoid fractures. Methods From July 2003 to July 2008, 26 patients with types Ⅱ and Ⅲ odontoid fractures were treated surgically. There were 18 males and 8 femalses, at age range of 22-65 years ( average 43 years). The patients were divided into Gallie titanium cable fixation group (Gallie group, n = 14) and C1 -C2 posterior screw fixation group using Harms technique (Harms group, n = 12) according to treatment methods to compare blood loss, operation duration, costs, hospital stay, bone fusion time, complications and secondary operation. Results The patients were followed up for 18-84 months ( average 37.3 months). The average blood loss and costs in Gallie group were significantly less than that in Harms group (P<0.05), while the time for back to work in Gallie group was significantly longer than that in Harms group ( P < 0. 05 ). There was no statistical difference upon operation duration, hospital stay and bone fusion time in two groups (P > 0. 05 ). There was one patient with nonunion and two with delayed union in Gallie group and one with secondary operation due to implant failure in Gallie group, and one with secondary debridement due to wound infection and one with delayed wound healing in Harms group, with no statistical difference (P > 0. 05). Conclusions Both Gallie technique with titanium cable fixation and Harms C1,2 screw fixation have advantages of early walk and short hospital stay. Compared with the former, the latter technique costs more but can help early back to work.